| NPI | 1912974734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 22403) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD22403) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-10-28 |